Spokane County’s community drive-thru screening site had its lowest turnout all week on Wednesday, but local public health officials confirmed 21 new COVID-19 cases after labs returned results for people tested days ago.

The additional cases confirmed Wednesday brought the number of local patients to 54 and represented the biggest day-to-day jump in Spokane County since the outbreak began.

Statewide, officials estimated Washington had almost 2,600 confirmed cases – up about 110 from Tuesday – but a database error kept the state health department from providing an exact number. At least 132 people have died from COVID-19 in Washington.

Seventeen counties east of the Cascades reported 184 confirmed cases to the state health department Wednesday, including 51 in Yakima County and 27 in Grant County. At least five people have died from the disease in Eastern Washington but no one in Spokane County.

The week in Spokane started with 29 local cases. That was a sharp rise from the 11 confirmed as of Friday when County Health Officer Dr. Bob Lutz declared a local public health emergency.

Close to 1,200 people had tested negative in Spokane County as of Tuesday.

Of the 54 cases countywide, 11 people are hospitalized, according to Kelli Hawkins, public information officer at the Spokane Regional Health District.

The jump in cases is due in part to an increase in testing capacity that came with the opening of the Spokane County Fair & Expo Center drive-thru screening site last week and by speedier results from labs, Hawkins said.

Hospitals are able to conduct tests for patients already receiving treatment, which could account for the increase in hospitalized cases.

The biggest challenge at the fairgrounds screening site is having enough test kits for officials to thoroughly identify who has COVID-19 and to isolate them from everyone else, according to Susan Sjoberg, Spokane Regional Health District’s operation section chief for its COVID-19 response.

The site had 1,000 kits when it opened last week, Sjoberg said, and officials put some limits on who could be tested in order to conserve kits for people who are most at risk or have more severe symptoms. She said more kits are arriving slowly, which could mean a lower threshold for people to be tested. The amount of supplies and number of people staffing the screening site have been adequate, Sjoberg said.

“The key at this time is still at least a fever of about 100 degrees or higher,” Sjoberg said. “Those are the individuals who are qualifying for testing.”

There is no charge for people who are screened at the fairground site, according to Julie Humphreys, Spokane public safety communications manager. If a person is selected to be tested, people will be asked for their health insurance so the provider can be billed.

“But patients will not see a bill,” Humphreys said.

People without insurance are tested for free, according to the Spokane Regional Health District.

As of Wednesday, the health district advised people with symptoms in high-risk categories – the elderly, those with underlying health conditions, first responders and health care providers – to come to the site for a screening after talking to a doctor first. But no one would be turned away, officials said.

“We’d like to be testing more people,” Sjoberg said as health care providers caught up to the morning rush for screening and only a few cars trickled through the screening site’s tent.

Mornings at the screening site are the busiest, with cars lining up outside the entrance along North Havana Street. Once screening starts at 10 a.m., cars stretch several hundred feet from the screening tent to the rear barrier in the parking lot, where a Spokane Valley police car sat Wednesday.

Volunteers wearing face masks stand near the back fence at a small, pop-up shelter explaining the screening process to drivers from a distance and letting them know there is no guarantee they’ll be tested.

“It’s usually been way more traffic than this,” said Tammy Marshall, a freelance writer who has volunteered at the site every day since Monday. Her parents’ backgrounds in health care inspired her to help because “I know what we’re up against.”

Marshall said she hopes her calm attitude can relax scared people at the screening site. Dozens of people have signed up to fill a maximum of 40 volunteer slots at the site each day.

Volunteer Bethany Laird, a master’s of public health student at Eastern Washington University, worked as a photographer stringing for many international news outlets while living with her father, who is a physician, in Liberia during the 2014 Ebola outbreak. She said she recognized many of the same fears in Washingtonians before she started volunteering Wednesday.

“I wanted to be involved in any way possible,” Laird said of the COVID-19 response. “Seeing how it’s escalated in the last couple months is frightening.”

And Bakari Harrison, who is now taking his Boise State University engineering classes online due to COVID-19, began volunteering at the site Monday when his girlfriend, a Providence employee, told him there was a need. The former Navy rescue swimmer jumped at the chance to “see if I can help.”

“It makes me feel like I can do something outside sitting at home,” Harrison said.

MultiCare Deaconess Hospital nursing supervisor Erik Gamble said from 30 to 40 health care workers and volunteers are at the site each morning prepared for the rush of cars. Gamble said he’ll be working 10-hour shifts Monday through Friday at the site until the outbreak subsides.

A nurse or a doctor, plus other medical assistants, staff each of the six stations prepared to screen cars as they pass through the tent.

The process – checking peoples’ vital signs, running through a series of screening questions and, if warranted, collecting a sample by inserting a 5-inch swab up a person’s nose – takes about 12 minutes.

Once the line is thinned out, Gamble said, health care workers can start to screen people in line and shorten the process in the tent.

On Wednesday, workers and volunteers earned a brief reprieve to grab slices of pizzas donated by MOD just after noon. But on Monday the lines remained full of cars until about 3 p.m., Sjoberg said.

Close to 1,000 people had been screened by doctors at the site as of Wednesday, including about 360 on Monday, 275 on Tuesday and 250 on Wednesday. Somewhere between 350 and 400 people have qualified for testing since last week. And at least three tests from the site had come back positive as of Sunday night.

Providence, which is leading the screening site’s testing effort, sends the samples to LabCorp in Arizona, according to Sjoberg, the Spokane Regional Health District supervisor. Most test results come back after three to four days. Providence health care workers then call people to notify them of their results.

Hawkins, the health district public information officer, couldn’t say how many people have been tested so far in Spokane due to individual medical providers also sending in samples. But more results should be coming back at a greater frequency due to the volume of screenings at the fairgrounds site and the higher capacity for testing at labs.

“It’s the limited swabs” that are limiting local testing, Sjoberg said. “Otherwise the set-up here, with the level of support across the health care system and with public health as a partner, it’s going extremely smoothly.”

Spokesman-Review reporter Arielle Dreher contributed to this report.